Wearable health monitoring device and methods for step detection

ABSTRACT

A wearable health monitoring device includes at least one sensor for obtaining a signal indicative of movement of a user in at least one axis and logic configured to determine, based upon the signal, whether the user has taken a step.

REFERENCE TO RELATED APPLICATIONS

This application claims priority to Provisional Patent Application U.S.Ser. No. 60/956,014, entitled “Wearable Health Monitoring Device andMethods for Motion Based Feature Extraction” and filed on Aug. 15, 2007,which is fully incorporated herein by reference.

FIELD OF THE DISCLOSURE

The present disclosure relates generally to the field of ambulatoryhealth monitoring, remote monitoring, motion sensing, digital signalprocessing, and activity monitoring devices. In particular, the presentdisclosure relates to devices which monitor one or more external signalswherein a change in such signals triggers detection, monitoring,recording, and reporting functions of the system. More particularly, thepresent disclosure relates to wearable devices to be used forphysiological health monitoring, activity assessment monitoring, humanstate monitoring, categorization of activity, and fall detection.

BACKGROUND OF THE DISCLOSURE

Ambulatory health monitoring devices are known in the field of medicalinstrumentation, in the field of computing, and in the field of wirelesssensor networks. Such devices are used for monitoring, recording, andreporting physiological signals. For example, ambulatory healthmonitoring devices typically include self-test devices such as weightscales for monitoring a user's weight; blood pressure cuffs formonitoring blood pressure; heart rate monitor for monitoring heart rate;temperature sensors for monitoring skin (or core body) temperature; etc.

Wearable devices form a special sub-class of ambulatory monitoringdevices. As a group, these have the added advantage that more continuousdata can be collected and data can be collected in the subject's [more]natural environment. Holter monitors for ECG and EEG monitoring areamong the first and most frequently used wearable devices. Currentdevices are limited, however, in that they are strictly data acquisitiondevices. Data is typically retrieved and analyzed post recordingsession.

When the devices are wirelessly enabled, they are also in the field ofwireless sensor networks (WSNs). WSNs are comprised of one or moresensor nodes and a system controller. Sensor nodes include a computingplatform with wireless communication capabilities and one or more sensordevices. The system controller provides a data sync point for thecollection and extraction of data, system configuration capabilities,and may include an interface for the end user of the wireless sensornetwork. The system controller may be referred to as a personal server,network coordinator or personal area network (PAN) coordinator. Thesystem controller may provide visual, audible or other signals to theuser in response to certain events.

Another category of health monitoring device includes the so calledPersonal Emergency Response System (PERS) devices. They are wearable,but strictly speaking are not monitoring any health information.Instead, they are an active alert response system. That is, the usermust press an emergency button to notify the monitoring center of anevent. This is intended for situations such as when the user falls andneeds outside assistance especially suited for independently livingelderly adults. These systems have the distinct disadvantage that theyrequire active participation from a user to be effective.

Certain measures of a user activity are often considered important andrelevant to the field of interest, but are not all available by currentstate of the art devices. These are defined herein: Fall Detectionrefers to the passive detection (no button requires pressing) of a userfalling down. Step Detection refers to the systematic detection of stepsas well as recording number of daily steps. Orientation or posturerefers to whether the user is horizontal or vertical. Category ofActivity, for purposes within, refers to whether the user is resting,standing/sitting, walking, or fast walking/running. Sleep/Wake patternsrefer to more general categories of activity (sleeping or not sleeping).Levels of Activity refer to any quantitative measure of activity such ascaloric expenditure or some other relative units for measuring activity.

SUMMARY OF THE DISCLOSURE

The present disclosure is directed to a wearable device intended formonitoring multiple physiological signals, recording metrics of health,and extracting measures of user state, user context, and categorizingactivity.

The present disclosure discloses a novel wearable health monitoringdevice for the purpose of monitoring, recording, and reporting relevantchanges in physiological signals or motion. The device includes amicroprocessor (or digital signal processor) at least one sensor formonitoring physiological data, a memory component for storing andretrieving information, and a means to communicate the data. When onesensor is a multi-axis accelerometer, methods are disclosed forextracting a number of pertinent motion-based features includingactivity estimation, fall detection, step detection, discerning thecategories of a user's activity, and recognizing sleep/wake patterns.

Feature extraction refers to the process of analyzing the signals,either post-session or, more desirably, in real-time as raw data iscollected, and interpreting the raw signals to extract more useful,application-level, signals or events. For example, heart rate andrespiration rate can be extracted from a raw electrocardiogram (ECO);core body temperature can be extracted from skin temperature. Inparticular, the disclosure disclosed within extracts a number offeatures from 3-axis accelerometer signals such as user orientation(posture), discerning category of activity, sleep/wake patterns, stepdetection, estimating levels of activity, and determining when the userfalls (fall detection). Activity-induced Energy Expenditure (AEE) refersto a measure of physical activity and close approximation to caloricexpenditure.

For purposes of summarizing the disclosure, certain aspects, advantages,and novel features of the disclosure have been described herein. It isto be understood that not necessarily all such advantages can beachieved in accordance with any one particular embodiment of thedisclosure. Thus, the disclosure may be embodied or carried out in amanner that achieves or optimizes one advantage or group of advantagesas taught herein without necessarily achieving other advantages as maybe taught or suggested herein.

These and other embodiments of the present disclosure will also becomereadily apparent to the those skilled in the art from the followingdetailed description of the embodiments having reference to the attachedfigures, the intention not being limited to any particular embodiment orembodiments disclosed.

BRIEF DESCRIPTION OF THE DRAWINGS

The present disclosure is described with reference to the accompanyingdrawings.

FIG. 1 is a perspective frontal view of an exemplary wearable healthmonitoring device in accordance with an embodiment of the presentdisclosure.

FIG. 2 is a perspective rear view of the wearable health monitoringdevice depicted in FIG. 1.

FIG. 3 is a perspective view of a runner donning the wearable healthmonitoring device depicted in FIG. 1 and a system in accordance with anembodiment of the present disclosure.

FIG. 4 is a block diagram depicting an exemplary computing system of thewearable health monitoring device as depicted in FIG. 1

FIG. 5 is a graph depicting a plurality of outputs of a 3-axisaccelerometer depicting a human standing, walking, and falling.

FIG. 6 is a graph depicting a portion of the graph depicted in FIG. 5from time=2 seconds to time=6 seconds.

FIG. 7 is a block diagram depicting exemplary architecture of thecontrol logic of the health monitoring device depicted in FIG. 4.

FIG. 8 is a block diagram depicting another exemplary architecture ofthe control logic of the health monitoring device depicted in FIG. 4.

FIG. 9 is a bar chart depicting exemplary activity-induced energyexpenditure.

FIG. 10 is a diagram depicting a 3-axis coordinate and a gravity vector.

FIG. 11 is a diagram depicting the resultant effect of the gravityvector on the 3-axis coordinate depicted in FIG. 10.

FIG. 12 is a flowchart depicting exemplary architecture andfunctionality of the control logic depicted in FIG. 4 for determiningwhether a user of the health monitoring device depicted in FIG. 1 hastaken a step FIG. 13 is a flowchart depicting exemplary architecture andfunctionality of the control logic depicted in FIG. 4 for determiningwhether a user of the health monitoring device depicted in FIG. 1 hasfallen.

FIG. 14 is a flowchart depicting another exemplary architecture andfunctionality of the control logic depicted in FIG. 4 for determiningwhether a user of the health monitoring device depicted in FIG. 1 hasfallen.

DETAILED DESCRIPTION

Ambulatory health monitoring can have many advantages including frequentmonitoring of health metrics, monitoring in the user's natural setting,early detection of abnormal physiological levels, and building a historyof user's health information. In addition, measures of an individual'sactivity (Activity-induced Energy Expenditure), number of daily steps,and their sleep/wake patterns are also generally deemed useful measuresof health information. Certain high need individuals, such as seniorsliving alone or individuals with chronic illnesses, may realize thegreatest benefit of ambulatory monitoring. Self-test devices such asthermometers, manual measurement of heart rate, and pedometers can beemployed to generate data related to ambulatory monitoring. Acomprehensive health monitoring device equipped with the ability tocontinuously monitor and assess activity could provide greater benefitto individuals wearing the device.

The present disclosure provides a wearable device which includes eithera microcontroller or digital signal processor (DSP), a battery, abattery management and power distribution system, and at least onephysiological sensor from the following list: electrodes for monitoringcardiac and other muscular activity; oxygen saturation sensors (SpO₂);galvanic skin response (GSR) sensors; multi-axis accelerometer formonitoring motion; angular rate sensor (or gyroscope); temperaturesensor.

FIG. 1 depicts an exemplary perspective view of a wearable healthmonitoring device 100 in accordance with an embodiment of the presentdisclosure. The wearable health monitoring device 100 comprises acontroller housing 103 and a strap 101, e.g., an elastic strap. Thecontroller housing 103 attaches to the strap 101 with two or moreelectrode snaps 104. The snaps 104 serve a dual purpose to both attachand secure as well as provide electrical connection to the elasticstrap's electrodes, which is described further herein with reference toFIG. 2. The wearable health monitoring device 100 further comprises aconnector 105 for fastening and/or tightening the elastic strap 101around a user's torso.

Note that the controller housing 103 may be comprised of any type ofsuitable material known in the art or future-developed, includingplastic. In one embodiment of the wearable health monitoring device 100,the controller housing 103 is comprised of a water resistant type ofmaterial. Thus, the wearable health monitoring device 100 can be usedduring bathing or swimming.

In one embodiment, the wearable health monitoring device 100 isperpetually in an activated state, i.e., powered on. The controllerhousing 103 further comprises an actuator 102 for signaling a remotedevice (not shown). The actuator 102 may be, for example, a button or aswitch that when actuated generates a message which is wirelesslytransmitted to the remote device, which is described further withreference to FIG. 3.

FIG. 2 depicts an exemplary perspective view of a back side of thewearable health monitoring device 100. The wearable health monitoringdevice 100 comprises one or more dry fabric electrodes 200 embeddedwithin the strap 101. In one embodiment, the electrodes 200 are made ofconductive polymer yarn and formed in a mesh. Each of the electrodesnaps 104 comprise on one side a snap female receptacle 205, which mateswith the controller housing snap male connector 206. Therefore, theelectrode snaps 104 are removeably attached to the controller hosing 103by inserting the male connector 206 into the female connector 205.

Each dry fabric electrode 200 embedded in the strap 101 is connected tothe female connector 205. In one embodiment, the female connector 205 isriveted through the mesh dry fabric electrode 200 thereby establishingan electrical connection between the electrode 200 and the femaleconnector 205.

Furthermore, the male connector 206 is conductively connected to aprinted circuit board (PCB) (not shown) within the controller housing103. Thus, when the male connector 206 is inserted within the femaleconnector 205, and electrical connection is made between the dry fabricelectrodes 200 and the PCB. In this regard, electrical signals picked upby the mesh dry fabric electrodes 200 are transmitted through the femaleconnector 205, the male connector 206 and to the PCB.

In one embodiment the wearable health monitoring device 100 furthercomprises one or more metal contacts 207. The metal contact 207 isconductively coupled to a thermistor (not shown) on the PCB, whichdetects temperature. In addition, the metal contact 207 further servesas a third lead of an electrocardiogram (ECG) signal.

In this regard, the first and second electrodes 200 serves as thedifferential leads of the ECG signal and are biopotential electrodes formeasuring biopotentials of the body and generating electrocardiogram(ECG) measurements. In such an embodiment, the electrodes 200 can beplaced so they are across a user's heart, and a differential measurementis used to obtain and record ECG data. In such an embodiment, the metalcontact 207 serves as the third lead when obtaining the ECG data.

In addition, the electrodes 200 may be used to detect a heartbeat of theuser. Notably, heartbeat detection can be extracted in any manner knownor future-developed. In one embodiment, the electrodes 200 detect auser's heartbeat through R-peak detection. This can be in the form ofhardware or software detection of the maximum peak waveform contained inthe deflections in the tracing of the electrocardiogram (ECG),comprising the “Q,” “R,” and “S” waves, also referred to as the QRSComplex. The “Q,” “R,” and “S” waves represent the respectiveventricular activity of a Heart (not shown). As an example, in real-timethe wearable health monitoring device 100, via the electrodes 200,measures the elapsed time between each R-peak (hereinafter referred toas an “R-peak interval”), and the instantaneous heart rate may becalculated as the inverse of the measured R-peak interval.

The ECG data can be extracted from any various number of electrodeconfigurations ranging from two to twelve electrodes. The use of threeelectrodes (two dry fabric 200 and one metal 207) in FIG. 2 is forexemplary purposes only, and other numbers of electrodes in otherembodiments are possible.

In one embodiment, the electrodes 200 may be used to obtain respirationrate. In such an embodiment, the ECG signal is used to extractrespiration rate using a low frequency response filter (not shown). Thewearable health monitor device 100 performs such extraction by employinga low pass filter (LPF) (not shown) and determining the period of asignal (not shown) transmitted by the LPF. The low pass filter can beimplemented in hardware, in DSP firmware, or microcontroller software.

In one embodiment, the wearable health monitoring device 100 analyzes amagnitude of the QRS complex in the time domain and extracts a magnitudeof the R-peak as a function of time using the electrodes 200. Thewearable health monitoring device 100 then analyzes the derived signalto determine the period (detecting relative maximum), indicative of arespiration rate.

In one embodiment, the wearable health monitoring device 100 extractsmeasures of Heart Rate Variability (HRV). There are a number of acceptedmethods for representing HRV including time domain (standard deviation)and frequency domain representation. Notably, such an embodiment usesany suitable process known in the art of future-developed to representthe HRV. The wearable health monitoring device 100 calculates the HRV insystem or during post-analysis by analyzing a time series of heartbeats.

FIG. 3 depicts a system 300 in accordance with an embodiment of thepresent disclosure. The system 300 comprises the wearable healthmonitoring device 100, as depicted in FIGS. 1 and 2, which is being wornby a user 301. In addition, the system 300 comprises at least onedata-receiving unit 302. In such an embodiment, the wearable healthmonitoring device 100 communicates with the data-receiving unit 302 overa local network 321, e.g., Zigbee.

In addition, the data-receiving unit 302 and/or the monitoring device100 communicates with a central monitoring device 305 via a network 303.The network 303 may be any type of network known in the art offuture-developed. The network 303 may be, for example, broadband overpower lines (BPL), optical fiber, Ethernet, a local area network (LAN),a wireless local area network (WLAN), or a wide area network (WAN).Further, the data-receiving unit 302, the wearable health monitor 101,and the central monitoring device 305 comprise hardware and/or software(not shown) known in the art or future-developed for communicating overthe networks 321 and 303, which is described further herein.

In the system 300, the user 301 wears the wearable health monitoringdevice 100. As depicted in FIG. 3, one exemplary location of thewearable health monitoring device 100 is above the user's waist 308 sothat a static response (due to gravity) is in relation to an upper torsoregion 305 of the user 301. As described hereinabove, mounting thewearable health monitoring device 100 is accomplished by wrapping theelastic strap 101 (FIG. 1) around the user's chest 307 and connectingthe elastic strap 101 via the connector 105 (FIG. 1). Note that thehealth monitoring device 100 is worn around the chest 307 next to theskin, i.e., under the clothes of the user 301.

During operation, the wearable health monitoring device 100 transmitsphysiological data to the data-receiving unit 302. The device 100 maytransmit the physiological data to the data-receiving unit 302 uponrequest, continuously, or automatically at predetermined intervals. Thedata-receiving unit 302 receives the physiological data and generateshistorical health data related to the user 301 or detect particularevents based upon the physiological data received from the monitoringdevice 100.

As indicated hereinabove, the system 300 further comprises the centralmonitoring device 305. The central monitoring device 305 may besubstantially similar to the data-receiving unit 302. However, in suchan embodiment, the wearable monitoring device 100 provides real-timephysiological data related to the user 300 to a device monitor 304,e.g., an individual, via the central monitoring device 305.

During operation, if an event occurs, e.g., there is a change in theuser's respiration or heartbeat, the central monitoring device 305displays data indicative of the event on a graphical user interface(GUI) (not shown). Based upon the displayed data, the device monitor 304can take an action based upon the physiological data indicative of theevent, e.g., call emergency personnel for the user 301.

Note that in the embodiment shown in FIG. 3, the device monitor 304 isdepicted graphically as a person. However, the central monitoring device305 may automatically, upon receipt of the physiological data,electronically notify emergency personnel.

During operation, the wearable health monitoring device 100 extractsfeatures specifically related to the user's motion, respiration, cardiacactivity, temperature, and the like. In order to extract such featuresrelated to motion of the user 301, an accelerometer described furtherwith reference to FIG. 4, is used, which extracts features based upon a3-axis coordinate system depicted in FIG. 3. Exemplary processes andmethods for extracting such features are described further herein, andinclude processes for estimating the user's level of activity orapproximating caloric expenditure, categorizing user activity, detectinga fall, step detection, or orientation detection, for example.

FIG. 4 is a block diagram depicting an exemplary controller 400 of thepresent disclosure that is contained in the controller housing 103(FIG. 1) of the wearable health monitor 100 (FIG. 1).

The exemplary controller 400 comprises a processor 403, an output device405, an input device 404, a communication device 410, and a power supply409. In addition, the exemplary controller 400 comprises a thermistor407 and one or more bioamplifiers 408. Each of these componentscommunicates over local interface 407, which can include one or morebuses. Furthermore, the controller 400 comprises an accelerometer 406and an analog-to-digital converter (ADC) 413.

Controller 400 further comprises control logic 402, physiological data411, motion data 414, and control data 412. Control logic 402 can besoftware, hardware, or a combination thereof. In the exemplarycontroller 400 shown in FIG. 4, control logic 402, is shown as softwarestored in memory 401. Memory 401 may be of any type of memory known inthe art, including, but not limited to random access memory (RAM),read-only memory (ROM), flash memory, and the like.

As noted hereinabove, control logic 402, physiological data 411, motiondata 414, and control data 412 are shown in FIG. 4 as software stored inmemory 401. When stored in memory 401, control logic 402, physiologicaldata 411, motion data 414, and control data 412 can be stored andtransported on any computer-readable medium for use by or in connectionwith an instruction execution system, apparatus, or device, such as acomputer-based system, processor-containing system, or other system thatcan fetch the instructions from the instruction execution system,apparatus, or device and execute the instructions.

In the context of the present disclosure, a “computer-readable medium”can be any means that can contain, store, communicate, propagate, ortransport the program for use by or in connection with the instructionexecution system, apparatus, or device. The computer readable medium canbe, for example but not limited to, an electronic, magnetic, optical,electromagnetic, infrared, or semiconductor system, apparatus, device,or propagation medium

Processor 403 may be a digital signal processor (DSP) or other type ofcircuitry configured to run the control logic 402 by processing andexecuting the instructions of the control logic 402.

The communication device 410 may be, for example, a low-powered radiodevice, e.g., a radio semiconductor, radio frequency antenna (RFantenna); a wired communication device such a RS232, USB, or Ethernet;or other wireless communication device, such as a magneticcommunications scheme or infrared scheme; or any type of communicationdevice, which communicatively couples the controller 400 to thedata-receiving device 302 (FIG. 3) and/or the central monitoring device305.

In an embodiment having a data-receiving unit 302, physiological data411 and motion data 414 can be relayed in a real-time manner, a periodicmanner, an “as they occur” fashion, or some combination of the three.For example, a serious condition such as an individual falling could berelayed to the central monitoring device 305 (FIG. 3).

In one embodiment, the bioamplifier 408 is a device that interfaces withthe electrodes 200. Thus, the bioamplifier 408 gathers, amplifies,filters and conditions the signal integrity of human physiologicalactivity for use by the control logic 402. The signals (not shown)collected by the bioamplifier 408 from the electrodes 200 relate to thenervous system of the user 301 (FIG. 3). In one embodiment, the signalscollected are stored as the physiological data 411, and are used by thecontrol logic 402.

The output device 405 is a device for communicating information to theuser 301 (FIG. 3). The output device 405 may be, for example, an LEDthat indicates that power is on. In addition, the output device 405 maybe a speaker that emits a sound upon the occurrence of a particularevent, e.g., when the battery needs to be charged or upon activation.

Physiological data 411 includes data obtained from the one or moresensors, e.g., the thermistor 407 or the bioamplifier 408. Hence, thephysiological data 411 comprises data indicative of physiologicalaspects of the user 301 (FIG. 3). Examples of physiological data 411include data indicative of ECG readings, heartbeat readings, temperaturereadings, or the like.

Motion data 414 includes data obtained from the accelerometer 406.Hence, the motion data 414 comprises data indicative of movement of theuser. In the 3-axis accelerometer embodiment, the motion data 414includes data indicative of the user 301 in an X-direction, Y-direction,and the Z-direction.

The input device 404 enables the user 301 to enter data into thecontroller 400. In the exemplary controller 400, the input device 404 isthe actuator 102 (FIG. 1). When the actuator is selected, the controller400 recognizes this as a user button which generates a message which issent over the network 303 and is detected by the remote device monitor304. Other input devices may be used in other embodiments. For example,the input device 404 may be a keyboard or a touch screen for performingparticular operations on the controller 400.

In one embodiment, the input device 404 is a microphone (not shown), andan exemplary output device 405 is a speaker (not shown), as describedhereinabove. In such an embodiment, the speaker and the microphoneenable the user 301 to be in communication with the device monitor 304where the device monitor 304 is a person. In such an example, thewearable health monitoring device 100 detects an event, such as, forexample, a fall or a negative change in the user's physiologicalcondition based upon received physiological data 411. The centralmonitoring device 305 receives the physiological data 411 and alerts thedevice monitor 304 to the particular concern. The device monitor 304then contacts the user 301 over the network 303 via themicrophone/speaker input/output arrangement.

The thermistor 407 is conductively coupled to the metal contact 207(FIG. 2) as described hereinabove. The thermistor 407 is a device thatmeasures a skin temperature of the user 301 where the thermistor 407 isin contact with the metal contact 207, which is in contact with the skinof the user 301. In one embodiment, the thermistor 407 is a thermocouple(not shown) integrated with the housing 103, and the thermocoupleprotrudes from the backside of the housing 103. Placing it on thebackside of the control housing 103 places the thermocouple in directcontact with the user's skin. In such an embodiment, leads (not shown)from the thermocouple are attached to the controller 400.

In another embodiment, the metal contact 207 (FIG. 2) is mounted insidethe controller housing 103 and is mounted to the thermistor 407 of thecontroller 400. In such an embodiment, the thermistor 407 is mounted sothat either the thermistor 407 is in direct contact with the thermallyconductive metal contact 207 integrated with the controller housing 103for detecting physiological data 411 indicative of skin temperature orit is positioned so that an intermediary thermally conductive material(not shown) can connect to the thermistor 407 and the contact 207. Themetal contact 207 may be comprised of materials, such as, copper,aluminum, stainless steel, thermally conductive polymers or plastics. Inone embodiment, the metal contact 207 is made of a combination ofmaterials such as a thermally conductive gap filler connecting orthermal grease which connects the thermal contact 207 to the thermistor407.

In one embodiment, the accelerometer 406 is a 3-axis accelerometer formonitoring motion. The accelerometer 406 may be a direct current (“DC”)response or a non-DC response accelerometer. In one embodiment, theaccelerometer 406 is a microelectromechanical (“MEMS”) piezoresistivetechnology sensor (not shown), however other types of accelerometersknown in the art or future-developed may be used in other embodiments ofthe controller 400.

In one embodiment, the accelerometer 406 measures acceleration due togravity and physical movement and transmits the raw analog signals tothe ADC 413. The ADC 413 translates the received analog into digitaldata indicative of the received analog signals (not shown). The ADC 413provides the digital data indicative of the analog signals to thecontrol logic 402, which can store the digital data as motion data 414.The control logic 402 then calculates and stores additional motion data414 including activity-induced energy expenditure (AEE) and/ororientation, based upon the motion data 414. In addition, the controllogic 402 can use the motion data 414 to detect a fall, detect stepsmade by the user 301, and categorize activity performed by the user 301.

The accelerometer 406 may be a single (or dual) axis accelerometerarranged to create a three-axis orthogonal coordinate system, asdepicted in FIG. 3 as X, Y, and Z axes. FIG. 3 illustrates one possibleaxis orientation for a wearable health monitoring device including a3-axis accelerometer sensor.

During extraction of the physiological data 411 and motion data 414, thecontrol logic 402 reacts quickly to changes in real-time and alsoreduces the data stream, thereby maximizing the storage capabilities ofmemory 401. Reducing the data stream may refer to techniques foraveraging the data, or inspecting the real-time stream for certainfeature extraction. One such technique is described in U.S. patentapplication Ser. No. 11/972,335 entitled Wireless Sensor Network ContextData Delivery System and Method.

FIG. 5 is a graph 500 that illustrates digitized signals 501-503obtained from an accelerometer 406 (FIG. 4) wherein the accelerometer406 is a 3-axis accelerometer. As described herein, the accelerometer406 provides the raw analog signals to the ADC 413 before the signals501-503 are provided to the control logic 402.

The accelerometer 406 and ADC 413 from which the data plotted in thegraph 500 is obtained, is housed in the controller housing 103 (FIG. 1)by the user 301 (FIG. 3) in the upper torso position depicted in FIG. 3.As shown in FIG. 3, three axes, i.e., X-axis, Y-axis, and Z-axis, denotethe three dimensions of movement possible for the user 301 and for whichthe accelerometer 406 obtains signals.

The graph 500 comprises an “Acceleration” axis in “g” and acorresponding “Time” axis in seconds. Note that the symbol “g” refers tothe gravitational pull of Earth at sea level. In addition, the graph 500comprises the signal 501, the signal 502, and the signal 503, whichcorrespond to the X-axis, the Y-axis, and the Z-axis of FIG. 3. Thus,the signal 501 corresponds to movement of the user 301 in anX-direction, the signal 502 corresponds to movement of the user 301 in aY-direction, and the signal 503 corresponds to movement of the user 301in a Z-direction. Each signal is indicated in the legend as Ax, Ay, andAz, respectively.

The graph 500 depicts approximately two seconds of idle standing, fromTime=0 seconds to Time=2 seconds. Further, the peaks indicated in eachnotation 501-503 from approximately Time=3 seconds to Time=7 secondsrepresent approximately four seconds of walking (six discrete stepsdepicted) followed by a fall at approximately Time=8 seconds. The falllasts approximately two seconds from Time=7 seconds to Time=9 seconds,followed by a change in orientation and a period of inactivity afterTime=9 seconds.

The change in orientation is indicated by the change in location on theacceleration axis of the signals 501-503 following the fall. Note thatthis orientation is calculated as a function of the static response dueto gravity and how it acts on each axis. Hence, after the indicatedfall, the signal 501 in the X-direction changes from approximately 0 gprior to the fall to approximately Acceleration=1 g after the fall. Thesignal 502 in the Y-direction remains very near its original value, andthe signal 503 in the Z-direction changes from approximately 1 g priorto the fall to slightly less than 0 g after the fall. The change in theDC components of the acceleration values indicates a change inorientation. As an example, prior to the fall, the user 301 may havebeen in an upright position; however, after the fall, the user may nowbe in a supine position.

Furthermore, the notations 501-503 level at around Time=9 seconds, andthe signals 501-503 do not exhibit any steeply graduated peaks in theacceleration. This leveling out after the fall, i.e., after Time=9seconds, indicates a period of inactivity.

FIG. 6 is a graph 600 that illustrates in more detail the movement ofthe user 300 (FIG. 3) from Time=2 seconds to Time=6 seconds in the graph500 of FIG. 5. Note that the notations of the signals 501-503 remain thesame, i.e., signal 501 is indicative of movement in the X-direction,signal 502 is indicative of movement in the Y-direction, and signal 503is indicative of movement in the Z-direction.

The four-second period from Time=2 to Time=6 seconds encompassesapproximately four steps (walking), and the steps are indicated by thepeaks 601-604 in the Z-direction represented by signal 503. Each signal501-503 comprises peaks; however, for simplicity and brevity only thosepeaks in the Z-direction are identified in FIG. 6.

Additionally, there is a DC offset to each signal 501-503, and inparticular, there is an offset in the Z-direction represented by signal501 of 1 g. As indicated hereinabove with reference to FIG. 3, when theuser 301 is in an upright position, the Z-direction is most affected,relative to the other directions, by the static effects of gravity oracceleration in g. Thus, the offset of 1 g with respect to theZ-direction is greater than that in the X-direction and Y-direction,i.e., approximately 0 g in both cases. FIG. 7 depicts exemplaryarchitecture and functionality of the control logic 402 (FIG. 4) inaccordance with an embodiment of the present disclosure. Note that thecontrol logic 402 can be software, hardware, or any combination thereof.

As described with reference to FIGS. 4-6, the accelerometer 406, assumedfor purposes of illustration to be a 3-axis accelerometer, transmits rawanalog signals (not shown) detected by a respective sensor (not shown)of the accelerometer 406 corresponding to each of the X, Y, and Zdirections, to the ADC 413 (FIG. 4). The ADC 413 translates the analogsignals received into digital signals Ax, Ay, and Az 503, and providesthe signals to the control logic 402. Note that each of these signals501-503 comprises an alternating current (AC) component and directcurrent (DC) component. The ADC 413 then provides the digitized signals501-503 to the control logic 402.

FIG. 7 depicts an exemplary embodiment of control logic 402. In thisregard, the control logic 402 comprises three separate tiers 710-712that operate to manipulate each of the three separate input signals Ax501, Ay 402, and Az 503 provided by the ADC 413 (FIG. 4) into dataindicative of an AC component, i.e., AC(Ax′), AC(Ay′), and AC(Az′), anddata indicative of a DC component,i.e., DC(Ax′), DC(Ay′), and DC(Az′).

The circuits 710, 711, and 712 comprise low pass filters 701. The lowpass filters 701 remove high-frequency noise (not shown) of the inputsignal Ax 510, and Ax 503 and transmits as output the direct current(DC) portion of each of the signals DC(Ax′), DC(Ay′), and DC(Az′).

In addition, the signals Ax, Ay, and Az are transmitted to summationcircuits 703. The summation circuits 703 further receive the outputsignals DC(Ax′), DC(Ay′), and DC(Az′) from the low pass filter 701. Thesummation circuit 703 subtract the output signals DC(Ax′), DC(Ay′), andDC(Ax′) from the signals Ax, Ay, and Az to obtain the AC componentsAC(Ax′), AC(Ay′), and AC(Az′) of the signals Ax, Ay, and Az,respectively. Finally a post filter median or low pass filter is appliedto further smooth the signals AC(Ax′), AC(Ay′), and AC(Az′).

When implemented in firmware or software and stored in memory 401 (FIG.4), the motion data 414 (FIG. 4) indicative of the input signals Ax, Ay,and Az obtained from the accelerometer 406 are represented as a streamof discrete samples occurring in real-time, as defined by an applicationsampling frequency, the graphs of which are illustrated in FIGS. 5 and6.

FIG. 8 depicts another exemplary architecture and functionality of thecontrol logic 402 (FIG. 4) in accordance with an embodiment of thepresent disclosure. Note that the control logic 402 can be software,hardware, or any combination thereof.

As described hereinabove, the ADC 413 translates the analog signalsreceived into digital signals Ax 501, Ay 502, and Az 503, and providesthe signals to the control logic 402. Note that each of these signals501-503 comprises an alternating current (AC) component and directcurrent (DC) component. The ADC 413 then provides the digitized signals501-503 to the control logic 402.

The control logic 402 depicted in FIG. 8 comprises three separate tiers2010-2012 that operate to manipulate each of the three separate inputsignals Ax 501, Ay 502, and Az 503 provided by the ADC 413 (FIG. 4) intodata indicative of an AC component, i.e., AC(AX′), AC(Ay′), and AC(Az′),and data indicative of a DC component, i.e., DC(Ax′), DC(Ay′), andDC(Az′).

The circuit 2010 comprises a median or low pass filter 2002 with a verylow cutoff frequency. In an exemplary embodiment, this is set at 0.1 Hz.The filter 2002 is used to remove high-frequency noise of from thesignal Ax to obtain resultant signal Ax′. The signal AX′ is thentransmitted through a high pass filter 2004 to generate the alternatingcurrent portion AC(Ax′) only of the Ax′ signal.

In addition, the signal Ax′ is transmitted to a summation circuit 2003,and the summation circuit 2003 also receives the signal AC(Ax′) from thehigh pass filter 2004. The summation circuit 2004 subtracts AC(Ax′) fromthe input signal Ax′to obtain the DC component DC(Ax′) of the signal Ax.Note that in the embodiment shown in FIG. 8, a median filter can beapplied to post filter and further smooth the AC(Ax′) signal.

It is understood that there exists additional variations of thisarchitecture and functionality that result in similar intermediatesignals. For example, one embodiment employs DC extraction using a lowpass filter to achieve the DC component and subtracting the DC componentfrom the input signal to obtain the AC signal component, as is shown inFIG. 7, while in another embodiment, employs AC extraction using a highpass filter to obtain the AC component and subtracting the AC componentfrom the input signal to obtain the DC signal component, as shown inFIG. 8.

With reference to FIG. 4, the motion data 414 comprises data indicativeof a plurality of AC signals AC(Ax′), AC(A_(y)′), and AC(A_(z)′) and aplurality of DC signals DC signals DC(Ax′), DC(A_(y)′), and DC(A_(z)′).In order to calculate activity-induced energy expenditure (AEE), thecontrol logic 402 receives the plurality of generated signalsAC(A_(x)′), AC(A_(y)′), and AC(A_(z)′) from the motion data 414 or fromthe ADC 413, as described hereinabove. The control logic 402, uponreceipt of the signals AC(A_(x)′), AC(A_(y)′), and AC(A_(z)′),calculates AEE based upon the following formula:

$\begin{matrix}{{{{A\; E\; E} = {\int_{t}^{t + T}\sqrt{{{AC}\left( A_{x}^{\prime} \right)}^{2} + {{AC}\left( A_{y}^{\prime} \right)}^{2} + {{AC}\left( A_{z}^{\prime} \right)}^{2}}}},}\ } & {A{.1}}\end{matrix}$where T is the integration period.

Note that an integration period in formula A.1 is application dependent.In one embodiment, the integration period t to (t+T) is one minute,i.e., T=60 seconds. The calculated AEE is useful for interpreting themagnitude of a response. For exemplary purposes of algorithms andmethods employed by control logic 402, AEE is of the order ofapproximately one second in period (T=1 second).

In one embodiment, the control logic 402 implements the integral fromdiscrete samples of the signals AC(A_(x)′), AC(A_(y)′), and AC(A_(z)′)stored as motion data 414 by calculating a cumulative sum of thesamples. As an example, for each T/f, discrete sample (where f_(s)represents the application sampling frequency), the control logic 402calculates the square root of AC(A_(x)′)²+AC(A_(y)′)²+AC(A_(z)′)² Thesum of these values represents an AEE for a given time, T. When thesignals are processed in real-time, a temporary variable is firstinitialized to zero (every T/f_(s) operations) and a cumulative sum isgenerated. The AEE result is available every T/f_(s) operations.

As an example, FIG. 9 shows AEE for a one second integration periods ascalculated over an entire ten second time interval. Each second thecontrol logic 402 performs the squared summation provided for in formulaA.1, and the graph 1100 is a bar graph showing the magnitudes of the AEEover the ten second time interval.

In addition to calculating AEE, the control logic calculates anorientation of the user 301 (FIG. 3) based upon the DC signals DC(Ax′),DC(Ay′), and DC(Az′) stored as motion data 414. For the purpose of thepresent disclosure, orientation of the user 301 refers to whether theindividual's upper torso region is horizontal or vertical.

Orientation

With reference to FIGS. 10 and 11, the control logic 402 receives andanalyzes the signals DC(A_(x)′), DC(A_(y)′) and DC(A_(z)′) to determinean angle Φ between the z-dimension axis and the effect of gravityrepresented by the vector “1 g.” FIG. 11 depicts the static effects ofgravity and how the vector “1 g” is measured on each axis X, Y, and Z.FIG. 13 shows the effect of gravity on each axis prior to a fall, wherethe user was in the vertical orientation and just after a fall, wherethe user was in a horizontal orientation.

The present disclosure discloses a method for calculating this angle Φas a function of DC(A_(x)′), DC(A_(y)′), and DC(A_(z)′). The anglebetween any two vectors can be determined by taking the dot product:u·v=|u∥v| cos φ

Let u be the ideal unit vector experienced if the accelerometer wascompletely vertical and gravity acted in 1 g in the z-axis. Then,u=(0,0,1)

And let v be the vector experienced in the current orientation:v=DC(x′),DC(y′),DC(z′)

Then the angle Φ is calculated as follows:

$\phi = {{\cos^{- 1}\left( \frac{u \cdot v}{{u{}v}} \right)} = \frac{1 \times {{DC}\left( z^{\prime} \right)}}{1 \times \sqrt{{{DC}\left( x^{\prime} \right)}^{2} + {{DC}\left( y^{\prime} \right)}^{2} + {{DC}\left( z^{\prime} \right)}^{2}}}}$

One embodiment of the present disclosure categorizes horizontal andvertical orientation in terms of Φ as follows:

Angle Φ Orientation Φ < β or Φ > γ Vertical B < Φ < γ Horizontal Where0° < β < 90° and 90° < γ < 180°

Yet another embodiment simplifies the calculation by recognizing thatthe angle Φ is a function only of DC(A_(z)′) and the magnitude of thevector formed by gravity. Because the magnitude of the measured vectorshould be very near 1 g, it can be approximated—thus avoiding theinverse cosine calculation—by forming a look-up table or simplecomparison based on DC(A_(z)′). The following table illustrates onepossible method:

DC(z′) Orientation DC(z′) > k_(h1) or DC(z′) < k_(h2) Vertical k_(h1) >DC(z′) > k_(h2) Horizontal Where cos(0°) > k_(h1) > cos(90°) andcos(90°) > k_(h2) > cos(180°)

Yet another embodiment first compensates for offset from the initialdevice placement as described within “Wireless Sensor Network System AndMethod For Using The Same”, U.S. Provisional Patent Application No.60/884,352, filed Jan. 10, 2007. Using the methods contained withincombined with those disclosed in this present disclosure, it is possibleto extract orientation even when the device is erroneously worn—such asif it were placed upside down.

Step Detection

In addition to calculating orientation and AEE, the control logic 402further detects steps performed by the user 300 (FIG. 3) as describedwith reference to FIG. 12. In order to determine whether a step hasoccurred by the user 300, the control logic continuously monitors thesignals AC(A_(x)′), AC(A_(y)′), and AC(A_(z)′).

FIG. 12 is a flowchart depicting exemplary architecture andfunctionality of the control logic 402 for detecting a step of a user301 (FIG. 3). The control logic 402 initially remains idle, as indicatedby step 1201 until a minimum amount of activity energy estimation (AEE)has met or exceeded a threshold “K,” as indicated in step l202.

A step is determined by detecting a relative minimum followed by arelative minimum on the post filtered AC(Az′) signal within a given timewindow and further qualifying by assuring the user is not in a supineposition (using intermediate signal orientation).

Next the control logic 402 determines whether there has been a relativeminimum of the post-filtered AC(Az′) as indicated in step 1203. In oneembodiment, the control logic 402 detects the relative minimum from thesignal AC(Az′) by comparing each digital sample in AC(A_(z)′) to one ormore previous and subsequent samples in AC(Az′). Thus, a relativeminimum is detected when the current discrete sample is less than theprevious sample and the following sample is greater than the currentsample.

If there is not a relative minimum in step 1203, the control logic 402remains idle; however, if there is a relative minimum, the control logic402 determines whether there is a relative maximum from signalAC(A_(z)′) in step 1204. Similar to the discussion with reference tostep 1203, the control logic 402 detects the relative maximum from thesignal AC(Az′) by comparing each digital sample in AC(A_(z)′) to one ormore previous and subsequent samples in AC(Az′). Thus, a relativemaximum is detected when the current discrete sample is greater than theprevious sample and the following sample is less than the currentsample.

If there is not a relative maximum in step 1204, the control logic 402remains idle; however, if there is a relative maximum, the control logic402 determines if the user is in a non-horizontal orientation, asindicated in step 1205.

Having satisfied the sequence of events identified in steps 1201-1205,the control logic 402 stores motion data 414 indicative of a step havingbeen performed at the particular time, as indicated in step 1206. If theprecise time occurrence of the step is of importance to the application,this can be defined by the user and stored as control data 412.

In another embodiment, the magnitude of the relative maximum andrelative minimum can be used to further qualify the step detection. Inyet another embodiment, the phase relationship between other axes couldbe examined to further qualify the step.

In one embodiment of the present disclosure, the control logic 402monitors the number of steps taken by the user 301 over time. In thisregard, the control logic 402 can start a counter and each time a stepis detected and stored in step 1206, the counter can be incremented.After a given time interval, for example sixty seconds, the controllogic 402 can stop the counter and store motion data 414 (FIG. 4) inmemory 401 (FIG. 4) indicating the number of steps taken during the timeinterval. The control logic 402 can transmit this motion data 414 to thecentral monitoring device 305 for storage, display, or further analysis.

Fall Detection

FIG. 13 is a flowchart illustrating exemplary architecture andfunctionality of the control logic 402 for detecting a fall of the user301 in accordance with an embodiment of the present disclosure.

As described hereinabove, control logic 402 remains in an idle state, asindicated in step 1301. The control logic 402 determines if the user 301is in a vertical position, as indicated in step 1302. If the user is ina vertical position, then the control logic 402 compares a calculatedAEE with a predefined threshold “k,” as indicated in step 1303. Thethreshold k is set sufficiently high so as not to be exceeded by normalactivity levels. In another embodiment, AEE is sampled more often andAEE threshold exceeding can be determining if n out of m consecutive AEEsamples are above k. In yet another embodiment, this can be furtherqualified to ensure that at least one of the m sampled AEE values isabove a higher threshold j, where j>k.

The control logic 402 then determines whether there is a change inorientation from vertical to horizontal, as indicated in step 1304. If acontinued horizontal state with relatively low activity (AEE<l and l<<k)for some period of time, as indicated in step 1305, the control logic402 takes action, in step 1306, e.g., stores data indicative of a fallor alerts the central monitoring device 305.

If while in steps 1301-1304, an event does not transpire in a reasonableelapsed time, the control logic 402 returns to the idle (appropriateorientation) state in step 1301.

FIG. 14 depicts additional architecture and functionality of the controllogic 402 for determining a fall. In step 1401, the control logic 402remains idle, until the control logic 402 determines whether the user301 (FIG. 3) is vertical, in step 1402.

In step 1404, the control logic 402 determines whether there is a changein orientation from vertical to horizontal. If the control logic 402determines that the user 301 is in a continued horizontal state withrelatively low activity (AEE<l) for some period of time, as indicated instep 1405, the control logic 402 takes action in step 1406. In thisregard, the control logic 402 may store data indicative of a fall or thecontrol logic 402 may transmit an alert to central monitoring device 305(FIG. 3).

Category of Activity

In one embodiment of the present disclosure, the control logic 402categorizes activity of the user 301 based upon data received. Thepresent disclosure discloses a method for categorizing user activity.Using a microcontroller or DSP and having employed the signal processingarchitecture disclosed in present disclosure, derived signalsOrientation, AEE, and Steps are of interest. The method provides fordiscerning four categories of activity: sleeping, sitting or standing,walking, and running.

The table below defines these categories of activity in terms oforientation, AEE, and whether or not steps are being detected.

Orientation AEE Steps Detected Category of Activity Horizontal AEE < k —Resting¹ Vertical — No Standing or Sitting Vertical l < AEE < m YesWalking Vertical AEE > m Yes Vigorous Walking or Running Where k << l <<m

Although not explicitly depicted in the above table, the presentdisclosure also discloses monitoring of other physiological signals ifavailable. For example, while the user is horizontal, it is imperativeto ensure that the individual is okay. Heart rate, if available,provides a good indication of this and can be used to differentiatesleeping and other life threatening situations. In addition, the abovetable does not accommodate history and in the case of a user havingsuffered a fall, software should keep state of this and use it toqualify the categorized activity. That is, a user is only sleeping ifhaving not suffered a fall and all vitals are still okay. In addition,all extracted features should be qualified with whether the device isbeing worn. A method for determining if the device is being worn isdisclosed within the present disclosure.

The present disclosure discloses a method for discerning periods ofsleep and wake. For present purposes, sleep and wake are more simplycategorized by sleep and not sleep. Based on the methods forcategorizing activity which has already been disclosed, it becomespossible to recognize periods of rest and consequently periods ofnon-rest. For most purposes, rest and sleep are synonymous.

One embodiment, however, makes use one or more of heart rate,respiration, and skin temperature sensors when available. In general,heart rate, respiration rate, and skin temperature decline whilesleeping. Under such embodiments, the present disclosure discloses amethod for discerning rest from sleep by recording these parameters atonset of rest. If the parameters fall below a certain threshold(relative to recorded parameter at onset of rest), then the activity canbe categorized as sleep.

Device Removal

In one embodiment of the present disclosure, the control logic 402detects whether the device 100 has been removed. Notably, when dryelectrodes 200 (FIG. 2) and a metal electrode 207 (FIG. 2) are used,heart beat detection stops and the detected temperature begins to dropquickly if the device 100 is removed from the user 300. In this regard,device removal can be defined as no heart beat and temperature below athreshold. At the beginning of onset of absence of heart beats, the rateof change of temperature must also be used as a determination.

In another embodiment, the control logic 402 uses the electrodes 200 andapplies a small potential to the body. By measuring the induced current,it can be determined if the electrodes 200 are in contact with theuser's body. If current is induced, the electrodes 200 are in contactwith a conductive body and can be determined to be being worn. This canbe accomplished by providing a voltage source with a known impedance (avoltage follower amplifier in series with a resistor) and measuring thevoltage on the output of the voltage source. If the measured voltage isat or near the source voltage, the loop is open and not in contact withskin. If the measured voltage is significantly lower than the sourcevoltage, then it can be determined that the loop is closed and currentis flowing thus causing a voltage drop in the resistive output of thevoltage source. It can then be inferred that the electrodes are incontact with a conductive material (presumably human skin). If deemednecessary, this could be further qualified for known resistiveproperties for humans so as to differentiate from a scenario where thedevice was laid on another non-human conductive surface.

This disclosure may be provided in other specific forms and embodimentswithout departing from the essential characteristics as describedherein. The embodiments described above are to be considered in allaspects as illustrative only and not restrictive in any manner.

As described above and shown in the associated drawings, the presentdisclosure comprises a wearable health monitoring device and methods formotion-based feature extraction. While particular embodiments of thedisclosure have been described, it will be understood, however, that thedisclosure is not limited thereto, since modifications may be made bythose skilled in the art, particularly in light of the foregoingteachings. It is, therefore, contemplated by the appended claims tocover any such modifications that incorporate those features or thoseimprovements that embody the spirit and scope of the present disclosure.

What is claimed is:
 1. A step detection device configured for detectinga step of a user, comprising: an accelerometer configured to be coupledto the user's torso and further configured for continuously measuringmovement of the user and outputting three signals indicative of themovements of the user in three orthogonal axes, wherein each signalcomprises an alternating current (AC) component representing dynamicmotion and a direct current (DC) component representing static effectsdue to gravity; and a processor electrically coupled to theaccelerometer and configured for periodically sampling the three signalsand storing digital data indicative of the three signals in a memory,wherein the memory is electrically coupled to the processor, theprocessor further configured for calculating activity induced energyexpenditure (AEE) values based upon the AC components of the sampledsignals and wherein AEE is a function of the AC components calculatedover an integration period, the processor further configured todetermine that the user has taken a step when: (a) the processordetermines when one of the AEE values calculated from the AC componentsexceeded a first threshold, wherein the first threshold is of amagnitude that indicates activity levels that are above stationaryactivity levels, (b) after the processor determines that one of the AEEvalues has exceeded the first threshold, the processor compares a seriesof consecutive AC components following the AC component of the AEE valuethat exceeded the threshold to determine when one of the consecutive ACcomponents has a value less than the other consecutive AC components,(c) after the processor determines that one of the consecutive ACcomponents has a value less than the other consecutive AC components,the processor determines when one of the consecutive AC components has avalue greater than the other consecutive AC components, (d) after theprocessor determines when one of the consecutive AC components has avalue greater than the other consecutive AC components, the processordetermines whether the user is vertical, and (e) when the processordetermines the user is vertical, the processor stores data in the memoryindicative of a step, the processor further configured to transmit thedata indicative of the step to a central monitoring device automaticallyor in response to user input, and the central monitoring device isconfigured to provide the data indicative of the step to a serviceprovider such that the service provider may determine the user'swell-being.
 2. The step detection device configured to detect a step ofthe user of claim 1, wherein the processor is further configured forfiltering the AC component from each of the three signals indicative ofmovement of the user and outputting the respective DC component of eachof the three signals indicative of movement of the user for furtherprocessing.
 3. The step detection device configured to detect a step ofthe user of claim 2, wherein the processor is further configured forsubtracting each of the DC components from a respective one of thesignals indicative of movement of the user and outputting the respectiveAC component of each of the three signals indicative of movement of theuser for further processing.
 4. The step detection device configured todetect a step of the user of claim 1, wherein the processor is furtherconfigured for filtering the DC component from each of the three signalsindicative of movement of the user and outputting the respective ACcomponent of each of the three signals indicative of movement of theuser for further processing.
 5. The step detection device configured todetect a step of the user of claim 4, wherein the processor is furtherconfigured for subtracting each of the AC components from a respectiveone of the signals indicative of movement of the user and outputting theDC component of each of the three signals indicative of movement of theuser for further processing.
 6. The step detection device configured todetect a step of the user of claim 1, wherein the processor is furtherconfigured for calculating the AEE over the integration period by: (1)calculating the square root of the sum of the squares of the ACcomponents for each discrete sample during the integration period; and(2) summing the calculated values for each discrete sample during theintegration period, wherein the sum is the AEE.
 7. A step detectionmethod for detecting a step of a user, comprising: measuring movement ofthe user with an accelerometer configured for coupling to a user'storso; outputting, by the accelerometer, three signals indicative of themovement of the user's torso in three orthogonal axes, wherein eachsignal comprises an alternating current (AC) component representingdynamic motion and a direct current (DC) component representing staticeffects due to gravity; periodically sampling the three signals with aprocessor coupled to the accelerometer; storing, by the processor,digital data indicative of the sampled signals in a memory, wherein thememory is electrically coupled to the processor; periodicallycalculating, by the processor, activity-induced energy expenditure (AEE)values based on the AC components of the sampled signals and wherein AEEis a function of the AC components calculated over an integrationperiod; determining, by the processor, that the user has taken a stepwhen: (a) the processor determines when one of the AEE values calculatedfrom the AC components exceeded a first threshold, wherein the firstthreshold is of a magnitude that indicates activity levels that areabove stationary activity levels, (b) after the processor determinesthat one of the AEE values has exceeded the first threshold, theprocessor compares a series of consecutive AC components following theAC component of the AEE value that exceeded the threshold to determinewhen one of the consecutive AC components has a value less than theother consecutive AC components, (c) after the processor determines thatone of the consecutive AC components has a value less than the otherconsecutive AC components, the processor determines when one of theconsecutive AC components has a value greater than the other consecutiveAC components, (d) after the processor determines when one of theconsecutive AC components has a value greater than the other consecutiveAC components, the processor determines whether the user is vertical,and (e) when the processor determines the user is vertical, theprocessor stores data in the memory indicative of a step, transmittingthe data to a central monitoring device automatically or in response touser input; and providing the data, by the central monitoring device, toa service provider for use in determining the user's well-being.
 8. Thestep detection method configured to detect a step of the user of claim7, further comprising: filtering, by the processor, the AC componentfrom each of the three signals indicative of movement of the user; andoutputting, by the processor, the DC component of each of the threesignals indicative of movement of the user for further processing. 9.The step detection method configured to detect a step of the user ofclaim 8, further comprising: subtracting, by the processor, each of theDC components from a respective one of the signals indicative ofmovement of the user; and outputting, by the processor, the ACcomponents of the three signals indicative of movement of the user forfurther processing.
 10. The step detection method configured to detect astep of the user of claim 7, further comprising filtering, by theprocessor, the DC component from each of the respective signalsindicative of movement of the user; and outputting, by the processor,the AC component of each of the three signals indicative of movement ofthe user for further processing.
 11. The step detection methodconfigured to detect a step of the user of claim 10, further comprising:subtracting, by the processor, each of the AC components from arespective one of the signals indicative of movement of the user; andoutputting, by the processor, the DC components of the three signalsindicative of movement of the user for further processing.
 12. The stepdetection method configured to detect a step of the user of claim 7,further comprising: calculating, by the processor, the AEE over theintegration period by: (1) calculating the square root of the sum of thesquares of the AC components for each discrete sample during theintegration period; and (2) summing the calculated values for eachdiscrete sample during the integration period, wherein the sum is theAEE.
 13. The step detection method configured to detect a step of theuser of claim 7, wherein the periodic calculating of AEE is performedfor each sample of the three measured signals indicative of movement ofthe user.